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Georgia Department of Technical
and Adult Education
Bloodborne Pathogens
Copyright © October 2002
by Georgia Department of Technical and Adult Education.
All rights reserved. No part of this manual may
be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording,
or by any information storage and retrieval system,
without written permission from Georgia Department of
Technical and Adult Education.
Published December 2002
(C121002)
Bloodborne Pathogens
Georgia Department of Technical and Adult Education
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Table of Contents
Introduction ........................................................................ 1
Objectives ............................................................................................... 1
What Are Bloodborne Pathogens? ........................................ 3
Hepatitis B Virus (HBV) ........................................................................ 4
Human Immunodeficiency Virus (HIV) ................................................ 4
Signs and Symptoms ............................................................ 5
Signs and Symptoms of (HVB) .............................................................. 5
Signs and Symptoms of (HIV) ............................................................... 5
Transmission ........................................................................ 7
Transmission Mediums ........................................................................... 7
Transmission Routes ............................................................................... 8
Risk Factors and Behaviors .................................................. 9
Personal Protective Equipment ........................................... 11
Decontamination & Sterilization ........................................ 15
Common Questions ........................................................... 17
Discuss with the class: .......................................................................... 17
HBV ..................................................................................................... 17
HIV ..................................................................................................... 18
Precautions ........................................................................ 19
Summary ........................................................................... 23
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Introduction
A bloodborne pathogen is a specific cause of disease, such as a virus or
bacteria. “Bloodborne” means carried by or in blood and certain other body
fluids. AIDS, hepatitis B and C, malaria, and syphillis are examples of
diseases that are caused by bloodborne pathogens.
Objectives
Upon completion of this course, you will be able to:
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Discuss bloodborne pathogens,
•
Identify two bloodborne pathogens of concern in
the workplace,
•
Explain how bloodborne pathogens are transmitted,
•
List four high risk factors, and
•
Discuss the precautions to be used in the workplace.
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What Are Bloodborne
Pathogens?
Two types of pathogens of concern in the workplace are:
1.
Hepatitis B Virus (HBV)
2.
Human Immunodeficiency Virus (HIV)
Hepatitis B is much more contagious than HIV.
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Hepatitis B Virus (HBV)
The HB Virus infects the liver: it’s more common than HIV and is a greater
risk on the job. Many HBV infected people have no problems or symptoms.
Some, however, do develop serious or fatal problems such as cirrhosis, liver
cancer, or chronic liver disease. There is a vaccine for HBV which is
dispensed in three doses. Any employee at risk should take the vaccine.
Human Immunodeficiency Virus (HIV)
HIV causes AIDS, it attacks the body’s immune system, reducing its ability
to fight disease.
To protect yourself against HIV and HBV, avoid direct exposure to infectious
blood or body fluids - the prime transmitters of HBV and HIV.
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Signs and Symptoms
Signs and Symptoms of (HVB)
Discuss and list different signs and symptoms of HVB.
Signs and Symptoms of (HIV)
Discuss and list different signs and symptoms of HIV.
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Notes:
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Transmission
Transmission Mediums
Body Fluids that can transmit infection are:
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Blood
•
Semen
•
Vaginal secretions
•
Cerebrospinal fluid (brain and spinal fluid)
•
Synovial fluid (lubricating fluid of joints and tendons)
•
Pleural fluid (fluid around the lungs)
•
Pericardial fluid (fluid around the heart)
•
Peritoneal fluid (fluid in the abdomen)
•
Amniotic fluid (fluid that surrounds an embryo)
•
Saliva (in dental procedures)
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Transmission Routes
HIV and hepatitis are transmitted only in the following ways:
1.
2.
3.
You can’t catch HIV through casual contact, such as touching,
hugging, being coughed on or sneezed on or working around
someone who has AIDS. Family members and health care
workers who are constantly around patients with AIDS do not
catch AIDS when they use proper precautions.
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Risk Factors and Behaviors
In light of what we know about the way the HBV and HIV virus are
transmitted, risk of exposure to either virus is increased for people who:
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Have unprotected sex or multiple partners.
•
Have unprotected sex with an IV drug user.
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Have shared needles while using drugs.
•
Have occupational exposure to the blood or body fluids
of others.
•
Between 1978 and the spring of 1985, received blood or
blood products in transfusion.
•
Between 1978 and the spring of 1985, received an
organ transplant.
•
Received artificial insemination from an untested donor.
•
Between 1978 and the spring of 1985, received treatment
for a clotting disorder.
•
Have been exposed to blood or body fluids of a person
known to have AIDS or be HIV-positive.
•
Are immigrants from high risk areas (southeast Asia, Africa,
Southern and Central Europe):
•
Have tattoos.
•
Are family of infected persons.
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Personal Protective
Equipment
"Universal Precautions" is the name used to describe a prevention strategy in
which all blood and potentially infectious materials are treated as if they are,
in fact, infectious, regardless of the perceived status of the source individual.
In other words, whether or not you think the blood/body fluid is infected
with bloodborne pathogens, you treat it as if it is. This approach is used in all
situations where exposure to blood or potentially infectious materials is
possible. This also means that certain engineering and work pratice controls
shall always be utilized in situations where exposure may occur.
Probably the first thing to do in any situation where you may be exposed to
bloodborne pathogens is to ensure you are wearing the appropriate personal
protective equipment (PPE). For example, you may have noticed that
emergency medical personnel, doctors, nurses, dentists, dental assistants, and
other health care professionals always wear latex or protective gloves. This is
a simple precaution they take in order to prevent blood or potentially
infectious body fluids fromcoming in contact with their skin. To protect
yourself, it is essential to have a barrier between you and the potentially
infectious material.
Discuss and List 4 Rules to Follow with PPE:
1.
2.
3.
4.
If you work in an area with routine exposure to blood or potentially
infectious materials, the necessary PPE should be readily accessible.
Contaminated gloves, clothing, PPE, or other materials should be placed in
appropriately labeled bags or containers until it is disposed of,
decontaminated, or laundered. It is important to find out where these bags
or containers are located in your area before beginning work.
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This approach is used in all situations where exposure to blood or potentially
infectious materials is possible. This also means that certain engineering and
work pratice controls shall always be utilized in situations where exposure
may occur.
Gloves
Gloves should be made of latex, nitril, rubber, or other water impervious
materials. If glove material is thin or flimsy, double gloving can provide an
additional layer of protection. Also, if you know you have cuts or sores on
your hands, you should cover these with a bandage or similar protection as an
additional precaution before donning your gloves. You should always inspect
your gloves for tears or punctures before putting them on. If a glove is
damaged, don't use it! When taking contaminated gloves off, do so carefully.
Make sure you don't touch the outside of the gloves with any bare skin, and
be sure to dispose of them in a proper container so that no one else will come
contact with them either.
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Personal Protective Equipment
Goggles
Anytime there is a risk of splashing or vaporization of contaminated fluids,
goggles and/or other eye protection should be used to protect your eyes.
Again, bloodborne pathogens can be transmitted through the thin
membranes of the eyes so it is important to protect them. Splashing could
occur while cleaning up a spill, during laboratory procedures, or while
providing first aid or medical assistance.
Face Shields
Face shields may be worn in addition to goggles to provide additional face
protection. A face shield will protect against splashes to the nose and mouth.
Aprons
Aprons may be worn to protect your clothing and to keep blood or other
contaminated fluids from soaking through to your skin. Normal clothing
that becomes contaminated with blood should be removed as soon as possible
because fluids can seep through the cloth to come into contact with skin.
Contaminated laundry should be handled as little as possible, and it should be
placed in an appropriately labeled bag or container until it is deconaminated,
disposed of, or laundered.
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Notes:
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Bloodborne Pathogens
Decontamination &
Sterilization
All surfaces, tools, equipment and other objects that come in contact with
blood or potentially infectious materials must be decontaminated and
sterilized as soon as possible. Equipment and tools must be cleaned and
decontaminated before servicing or being put back into use.
Decontamination should be accomplished by using:
•
A solution of 5.25% sodium hypochlorite (household bleach/
Clorox) diluted between 1:10 and 1:100 with water. The
standard recommendation is to use at least a quarter cup of
bleach per one gallon of water.
•
Lysol or some other EPA-registered tuberculocidal disinfectant.
Check the label of all disinfectants to make sure they meet
this requirement.
If you are cleaning up a spill of blood, you can carefully cover the spill with
paper towels or rags, and leave it for at least 10 minutes. This will help
ensure that any bloodborne pathogens are killed before you actually begin
cleaning or wiping the material up. By covering the spill with paper towels
or rags, you decrease the chances of causing a splash when you pour the
bleach on it.
If you are decontaminating equipment or other objects, you should leave
the disinfectant in place for at least 10 minutes before continuing the
cleaning process.
Of course, any materials you use to clean up a spill of blood or potentially
infectious materials must be decontaminated immediately, as well. This
would include mops, sponges, reusable gloves, buckets, pails, etc.
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Common Questions
Discuss with the class:
HBV
What symptoms do I have if I am suffering from hepatitis B infection?
Many people with HBV do not have any symptoms and feel perfectly well.
Occasionally, the hepatitis B infection may become active and make the
patient feel ill with nausea, have a loss of appetite, and become jaundiced.
What kind of outlook can I expect if I have a hepatitis B infection?
Many patients with the hepatitis B infection can expect to lead a full and
normal life. It is most important to regard yourself as a normal individual
who happens to be infected with hepatitis B. However, it is important to
take precautions not to spread the disease and to get medical checkups
regularly.
Can I get hepatitis from the vaccine?
No. The hepatitis vaccine is a safe and highly purified vaccine. It does not
contain any blood products or living or dead viruses.
What should be done if the second or third vaccine dose is delayed?
If the doses are delayed for less than one year, the remaining doses can be
resumed to complete the vaccination without the need to restart the
vaccination series. If the lapsed doses are more than one year apart, extra
doses or restarting of the series may be required for high risk individuals.
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HIV
What will the AIDS test tell me?
A positive result indicates the presence of antibodies to HIV, which has been
found in people with AIDS.
Does a negative test mean that I am not infected?
Unfortunately, no. Although the test is reliable, there is a “window”- some
say it’s six to twelve weeks, some say longer-when you could be developing
the antibody, but the test will still be negative. That’s why you need to be
retested at six to twelve weeks and again in 6 months.
If you test negative, but still carry HIV, it is still possible to transmit the virus.
Counseling will be provided when you receive your test results whether
they are negative or positive.
What happens if I test HIV positive?
Currently, there is no known therapy to reverse antibody status. If an
employee tests HIV positive, we recommend ongoing medical monitoring
and possible anti-retroviral (contains RNA for protein productions) drugs.
What is the prognosis?
Research indicates that HIV - positive individuals will eventually develop
AIDS. Currently, there is no treatment for AIDS and it is generally believed
to be eventually fatal. As discussed previously, there is a vaccine for hepatitis
B which is available to all employees at risk.
What HIV symptoms should I watch for?
Almost half of the people who contract HIV experience a flu-like illness six to
twelve weeks after exposure. Employees who experience an exposure incident
should report any illness that feels like the flu or mononucleosis, especially if
it is accompanied by fever, rash, or swollen glands.
Will my employer know the results of my test?
No. The health care professional will give the results of your tests to you
only. All records, including test results, relating to an exposure incident are
Strictly Confidential.
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Precautions
The following precautions should be taken by anyone who has had an
exposure incident so that others are not exposed.
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Inform sexual or needle-sharing partners so they can be tested
for the virus.
•
Inform physicians and other health care givers so they can
protect themselves.
•
Don't give any blood, tissue, organs, or semen.
•
Remove the organ donor designation from your driver’s
license.
•
Hold off on getting pregnant until your health care provider
says it is okay.
•
If you are pregnant, get counseling.
•
Don’t breast-feed.
•
Be careful not to expose others to your blood or bodily fluids.
•
Don’t share personal items such as toothbrushes, razors, etc.
•
Use a bleach solution of 1:10, 70% isopropyl alcohol or other
EPA-approved germicide to clean up any spills of blood.
•
Refrain from sexual activity, or at least take the following
precautions:
-
Limit the number of partners
-
Use latex condoms from start to finish, even if your partner
is HIV-positive.
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Job situations which may result in exposure include:
•
Job duties that bring you into contact with needles or other
sharp objects such as glass that might be contaminated with
infected blood.
•
Providing emergency first-aid assistance to co-workers.
Discuss with the class other circumstances in which exposure is
possible:
It is important that you use universal precautions to prevent becoming
infected by contaminated blood. Universal precautions means that all blood
and body fluids are considered a potentially infectious.
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Precautions
When first aid measures are needed, make sure that you adhere to
the following:
1.
Mouth-to-Mouth Breathing – The safest course of action is to
use a breathing mask whenever you are called on to give mouth-tomouth resuscitation.
2.
Controlling Bleeding – To help the victim without infecting yourself
(or the victim), wear rubber gloves.
While chance of infection on the job are small, why take unnecessary risks
with your life? Following the necessary safety precautions is the best way to
minimize risks.
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Summary
Bloodborne pathogens are a very real risk in the workplace. However,
protective measures are in place for employees at risk. To avoid infection of
bloodborne pathogens, it is very important to follow all precautions.
Knowing how infection occurs is the first step in preventing the spread of
disease. Certain factors and behaviors put employees at risk. Avoid these
behaviors as much as you can.
Education combined with practicing safe behaviors can save your life.
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